Individual provider Active NPI

Mark Charles Ruebke, RPH

  • Pharmacist
  • Urbana, IL
National Provider Identifier
1649308271
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Practice address
1208 N Cunningham Ave
Urbana, IL 61802-1801
Phone
(217) 383-8494
Fax
(217) 344-6737
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X IL Primary

Addresses

Primary practice location

1208 N Cunningham Ave
Urbana, IL 61802-1801

Mailing address

1865 S Forty Dr
Urbana, IL 61802-9646
Phone (217) 328-1789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051032422ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Foundation Hospital Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649308271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 S FORTY DR",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618029646",
            "telephone_number": "217-328-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 N CUNNINGHAM AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618021801",
            "telephone_number": "217-383-8494",
            "fax_number": "217-344-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUEBKE",
        "first_name": "MARK",
        "middle_name": "CHARLES",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.